Keywords

Public Health Ethics Issue

From the moment the COVID-19 pandemic first appeared in early 2020, the whole world quickly came together with stunningly successful solutions to minimize and eradicate the threat. Meanwhile, a deadly epidemic of armed violence has raged unchecked for decades across American cities with no end in sight. Vigorously embracing social determinants and promoting health equity as the most effective approach to achieving U.S. “healthy people” policy goals, the public health community has nevertheless been ineffectual in saving the thousands of mostly Black and Brown young lives cut short by a deadly weapon. What are the social determinants approaches to mitigating violence? How do they work? Might it make a difference for Black and Brown boys to know that their neighbors care about them, listen to them, and have their back? The following narrative suggests simple neighborliness as a social determinant of health for young boys living in urban neighborhoods plagued by racialized violence.

The American Public Health Association (APHA) has long considered violence to be a public health issue, but not until November 2018 did the APHA acknowledge racism as a factor in police violence (APHA Policy Statement Database 2018). Racist law enforcement is just one aspect of racialized violence defined as “physical acts and structural processes that prove injurious or deadly to Black people as Black people. The structural manifestations of racialized violence include unjust laws and normative practices that constrain the fulfillment of Black people’s basic needs (like safety) and diminish their pursuit of liberation from persistent oppression” (Guerda and Thompson 2019, 587). Conceptualizing the “toxic triad” of marginalization, distorted policing, and violence, Hannah Cooper and Mindy Thompson Fullilove are the first public health scholars to examine racialized police violence as a social determinant of health with an unbroken pattern of antecedents dating back to the Norman Conquest (Cooper and Fullilove 2020).

The convergence of the COVID-19 pandemic, economic disruption, and police violence in 2020 riveted long-overdue public attention on racial disparities in the United States. The undeniable fact that people of color bear disproportionate burdens of the pandemic, economic loss, and police violence is proving to be a pivotal transformation of American civic conscience, with the majority of Americans now believing – however belatedly – that Black Lives Matter (Thompson and Horowitz 2020).Footnote 1 For the first time in U.S. history, the time is right to make good on the promise of equal protection for Black lives: Freedom from racialized violence and social trauma, elimination of health disparities, and promotion of equity in all policies. It is time for the United States to build a culture of health for all Americans.

We learn from history that informal social practices are equally or perhaps even more important in changing the culture than legal and policy initiatives. Despite a half-century of explicitly legal racial equality, the white majority have yet to create a normative critical mass of inclusive, equitable social practices to dismantle the legacy of structural racism created by their forebears. However well intentioned, the white majority has failed to create the social change they claim to embrace. The ordinary white person who decries racial injustice may have no idea how to begin the work of repairing centuries of structural racism. This narrative responds to the dilemma of white inaction by focusing on moral repair as an intentional social engagement practice to redress the legacy and practice of structural racism and racialized violence. Moral repair is especially applicable to structural racism because it acknowledges the underpinnings of wrongdoing in healing fractured societal relationships.

Background Information

I have woven background material into the main narrative to emphasize how the practice of moral repair involves immersing oneself in the social and economic history of a community as well as owning responsibility for that history in order to begin the process of healing relationships. This is especially important for white people, many of whom are descendants of twentieth century immigrants to the United States who feel no personal culpability for institutional racist practices such as slavery or Jim Crow or for the privileges they enjoy just by being white in a racist society. This experiential narrative is a first-hand account of how white Americans, as beneficiaries of structural racism, can begin to take responsibility for initiating moral repair in their own communities.

Narrative

In 2005, I bought a house and moved into Albemarle Square, a new mixed-income community funded by the U.S. Department of Housing and Urban Development (HUD) in Historic Jonestown, one of Baltimore’s oldest and most distressed “Black Butterfly” neighborhoods of concentrated racialized poverty and neglect.Footnote 2 City planners designed the neighborhood to mitigate gentrification forces emanating from Baltimore’s downtown and Inner Harbor revitalization. As a somewhat elderly white professor with years of experience in health policy and planning focused on the livability challenges of cities, I was eager to be part of a diverse urban community. At the time, I was only theoretically aware of what living in the neighborhood would teach me about applying an equitylens to social determinants and health disparities in low-income majority-Black urban communities, but I welcomed the opportunity to be changed by the experience.

My new “market rate” community of 143 homes was built on the footprint of a demolished public housing complex surrounded by a patchwork of homeless shelters, public housing projects, historic sites, small museums, subsidized rental units, abandoned buildings, and vacant lots just a few blocks from Baltimore’s Inner Harbor, downtown, cultural attractions, Johns Hopkins Medical Institutions, and the Baltimore City Health Department. A midwestern transplant, I had lived in Baltimore for 30 years and thought I was familiar enough with the local culture to live comfortably and creatively in a mixed race, mixed income neighborhood. Then in 2015, Freddie Gray happened. A Black Butterfly kid who died while in police custody, Freddie became a symbol of the structural inequity and violence permeating cities like Baltimore. Scrutinizing my neighborhood, my city, and myself through the eyes of my black, brown, and poor neighbors, I realized that I had barely scratched the surface of the complex history and social dynamics of my neighborhood and the city I had lived in for so long.

In the 5 years since Freddie Gray’s death, Baltimore City residents have had time to reflect on the deep roots of structural racism, the culture of violence it fosters, and the role we all play either in perpetuating or repairing fractured race relations. As a white resident of a majority-Black, gentrifying neighborhood, I am sharing this narrative as a personal reflection on my experience of coming to understand the culture of racialized violence and learning the work of moral repair to build authentically just, caring, and neighborly relationships across boundaries of race, income, class, and age. This is a personal journey of moral repair that began by applying an equitylens to my own neighborhood – and myself – to understand racialized violence. This led to a deep interrogation of racist history and recognition that an informal “sanctuary space” of protective safety for neighborhood adolescents enmeshed in a culture of violence was a small but practical exercise in moral repair. From the outset, I knew that positive relationships with caring adults protect young people living with violence (David-Ferdon et al. 2016, 29). Reflecting on my experience in the light of history, I understood moral repair more clearly as a constructive response to racialized violence.

Racialized Violence and Moral Repair

The Health in All Policies (HiAP) framework acknowledges the frustrating irony of social determinants that rely on solutions well beyond the efficacious capacities of health policy and the healthcare system (Centers for Disease Control and Prevention2016). Only by galvanizing the moral will and agency of people, publicly and privately, can society begin to repair and prevent the devastating damage of racialized violence to the health of people and communities of color. Based on her research and international justice work with communities fractured by political violence, Margaret Urban Walker defines moral repair as “the process of moving from the situation of loss or damage to a situation where some degree of stability in moral relations is regained,” by which she means a collective normative confidence that shared values and principles will be observed, that wrongdoers will be held to account for their actions, and that victims of wrongdoing will be supported in reclaiming their lives (Walker2006, 6). Walker focuses on the need for communities to establish credibility and trust by holding themselves and individual members accountable for their actions and for setting things right for people who have suffered offense, harm, and anguish from wrongdoing by the community or its members (Walker2006, 24). Because the roots of racialized violence are so deep, it is impossible to understand it as a social determinant of health, much less “set it right,” without digging far into the past, as Cooper and Fullilove illustrate in their examination of racialized violence (Cooper and Fullilove 2020). I share some of that history in this narrative but hasten to add that the full story of racialized violence and its impact must include as primary sources the experience and perspectives of African Americans and other people of color. As a white person in a Black city, however, I can learn from the work of Black historians to own my part of the story and do the work of moral repair by setting things right in my own relational sphere.

Racialized Violence as a Health Issue

Like most U.S. cities, Baltimore embraces the U.S. national health goals of wellbeing and health in all policies in its own public health agenda.Footnote 3 Established over 200 years ago in response to a yellow fever public health crisis, the Baltimore City Health Department now struggles with an equally deadly crisis of fatal overdoses and homicides that claim hundreds of lives every year. Achieving its Healthy People goals is a challenge for Baltimore where poverty, trauma, and violence top the list of health determinants for children and adolescents. In addition to its infamously high murder rate, Baltimore’s overdose fatalities rank among the highest in the country. Preventing the threat and trauma of violence has become a key public health goal for Baltimore. As in many American cities, the demographic patterns reveal that Black boys and young men bear the brunt of violence and society’s moral failure to protect, nurture, and prepare them to become fully functional, responsible adults.

The statistics are staggering. A city of 620,000 residents, Baltimore saw 761 drug and alcohol-related deaths and 342 homicides in 2017. The homicide rate of 56:100,000 far surpasses the national average of 6.2:100,000, making Baltimore one of the nation’s most violent cities (Wen 2017, 2). More than 90% of Baltimore City homicide victims are Black; more than half are males between 18 and 30 years old. Most Baltimore homicides occur in Black Butterfly neighborhoods of concentrated poverty, longstanding racial segregation, and economic disinvestment exacerbated by the 2008 recession. Ninety-eight percent of Black Butterfly kids eat breakfast and lunch at school so they don’t have to work on math, English, and social skills with a hunger headache.

Behind the statistics looms a systematic apparatus of legal and normative practices that constrains African Americans in fulfilling even their most basic need for safety. The whole apparatus seems designed to maintain structural racism by undermining people of color in their pursuit of liberation from persistent oppression (Guerda and Thompson 2019, 587). In learning to own and repair this injustice as a neighbor and city resident, I see how important it is to examine how everyday occurrences and ordinary interactions shape a community culture and perpetuate an ethos of racialized violence. For most of my years in Baltimore, I lived in safe, peaceful communities where exposure to violence of any kind was limited mostly to television and movies. When I moved to my Jonestown house, it was still a construction site where guys lined up every night selling knockoffs and drugs, girls practiced dance moves on the sidewalk, kids played kickball in the street. One night a body was casually dumped on the street in front of my house by a passing car. It was hard to miss the undercurrent of violence permeating the neighborhood.

Growing Up Black in a Culture of Racialized Violence

Growing up in the Baltimore Black Butterfly, African American adolescents are caught in the predatory jaws of violence – gangs and police – every time they walk out the door. For people who want to understand Baltimore’s urban culture of racialized poverty and urban failure, Paul Attanasio’s TV series, Homicide: Life on the Streets (1993–1999) and David Simon’s, The Wire (2002–2008), offer a window into the struggles of Black Butterfly individuals caught in the web of distressed social, economic, and material conditions. In my neighborhood, older family members often work two or more part-time minimum-wage jobs to pay rent and keep food on the table, leaving kids to fend for themselves. The drug trade is more a quick hustle than a thoughtful career path. Without looking for it, trouble finds them in the unstructured hours and social spaces between school and sleep. This glaring poverty of opportunity is especially troubling given the overall wealth of the local economy; Baltimore ranks 19th among U.S. metro areas in Gross Domestic Production (GDP) and Maryland is one of the wealthiest states in the country (Bureau of Economic Analysis 2019, 2020). Baltimore boasts more than its share of upscale neighborhoods, fancy prep schools, exclusive country clubs, world-class institutions, and innovative tech ventures focusing on health and cybersecurity. In stark contrast, Black Butterfly kids live just blocks away from gleaming high-rise towers, upscale shopping, and glitzy restaurants as constant reminders of disparities and insurmountable barriers between the Black Butterfly world and the world of wealth and opportunity within their sight but beyond their reach. It is no wonder that the death of 25-year-old Freddie Gray in 2015 sparked a protracted wave of citywide protest and street violence. The crisis of civic conscience that erupted in the wake of Freddie Gray’s death found Baltimore unprepared for restoring public order, despite its reputation as a progressive city with world class health knowledge, technology, and healthcare.

Progressive Policy and the Legacy of Slavery

Marylanders are proudly progressive, especially in health and social policy. Without acknowledging Maryland’s foundation of enslaved labor and its long reach of slavery into the present, however, we cannot fully understand racialized violence. Baltimore’s relentless racialized violence constantly reminds us of a living legacy of inhumanity that the achievements of a few cannot quell or silence. Racial health disparities are deeply rooted in its history as a colonial port that not only traded in enslaved Black Americans but relied on enslaved labor to build a prosperous agricultural, manufacturing, and international trading economy that spearheaded the U.S. industrial revolution. For most of its history, Baltimore normalized subservience of a sizeable Black population.

During the American Revolution, Maryland’s enslaved Black population was second only to Virginia’s and continued to increase until the abolition of slavery. The community of free Black Americans also expanded as moral objections to slavery took hold in the American civic conscience. As the number of free Black people in Baltimore grew – from 927 in 1790 to 17,888 in 1830 – white Marylanders viewed their presence as a problem, imposing restrictions to control and subordinate them in order to protect and justify their own social status, privileges, and human property (Millward 2016). At the dawn of the Civil War, Maryland had the largest population of free Black Americans in the country. Failing secession by a single vote in the General Assembly, Maryland emerged from the Civil War with a legacy of racist values to apply racist institutional practices to the large and growing population of emancipated Black citizens.

The subsequent century and a half of discriminatory practices such as Jim Crow laws, redlining, “zero tolerance,” “stop and frisk,” and punitive social policies continued into the present as deeply embedded structural bias designed to subordinate Black Americans and deny them opportunities for fulfilling their full human potential (Millward 2015; Gimenez 2005). Nevertheless, thousands of Black Americans from the Deep South found opportunities to thrive and prosper in racially segregated Baltimore with well-paying professions and jobs in manufacturing, steel refineries, and shipping at the height of Baltimore’s industrial economy prosperity. By any measure, Frederick Douglass, Harriet Tubman, Eubie Blake, Benjamin Banneker, Vivien Thomas, Thurgood Marshall, Reginald Lewis, Elijah Cummings, Wanda Draper, and April Ryan exemplify high achievement. Although the Baltimore’s Black community is one of the most prosperous and educated in the country, many of them have never experienced the full measure of freedom and opportunity most white Americans take for granted. Instead, they have endured nearly four centuries of prejudicial treatment and systemic disadvantage. The Freddie Gray generation of kids know this in their bones and do their optimistic best to get on with a life filled with risks.

The Legacy of Jonestown

Jonestown is one of Baltimore’s invisible neighborhoods with a rich, complex history. Named after Englishman David Jones who is said to have built the first European house on the shores of the Baltimore Inner Harbor, Jonestown is an eclectic hodgepodge of rowhouses, historic sites, social service agencies, small shops, vacant lots, and rundown warehouses. The busy street traffic reflects its origins as Baltimore’s first commercial port in a bewildering juxtaposition of idealism and inhumanity infusing everyday existence. Within a few blocks, Quakers, Catholics, and Jews built communities, schools, and places to worship – mostly because they were forbidden to settle elsewhere in the city. Generations of sailors, traders, shopkeepers, dissidents, and immigrants from around the world also found Jonestown a welcoming place. They put down roots to build new lives as Irish, German, Italian, Polish, Greek, or Ukrainian Americans. Next to the Flag House Museum commemorating “the birth of the star-spangled banner” where Mary Young Pickersgill stitched the flag that flew over Fort McHenry as inspiration for the national anthem, a modest sidewalk plaque soberly reminds pedestrians that Baltimore’s slave trading pens were located on the same street.

In the 1950s, the city tore down blocks of crumbling rowhouses in and around Jonestown to build publicly funded residential towers with easy public transportation access to schools, shopping, and jobs. The project mostly benefited lower-income whites seeking an entrée into Baltimore’s working class economic and social mainstream. Twenty years later, segregation, riots, and white flight transformed Flag House Courts into one of the most distressed public housing high-rises in the entire country – a “black ghetto” of concentrated racialized poverty and violence that fragmented the surrounding neighborhood. Italians carved out Little Italy as a prosperous culinary destination; family businesses relocated to less risky locations; a sprawling concrete central post office building displaced blocks of homes and businesses; the redesigned Oldtown Market became a pedestrian island isolated from its historic social and economic context. The City met with little organized resistance as it began locating homeless shelters and social services in the neighborhood. Redesigned commuter corridors destroyed street neighborhoods and block-to-block connectivity. The only people who remained were those who could foresee no options to relocate. With an eroding tax base, civic leaders increasingly viewed funding for Baltimore inner city schools as wasteful and ineffective. Rarely expressed in explicitly racial terms, these views undermined efforts to provide Black Butterfly kids with ladders into the middle-class mainstream.

The post-industrial age dawned as Jonestown and adjacent neighborhoods were devolving into a concentrated economic geography of racialized poverty. In the 1980s, the complex racial dynamics of urban gentrification played a role in motivating James Rouse and Baltimore civic leadership to create the Baltimore Inner Harbor, a national model for revitalizing post-industrial waterfront downtown areas for investment, tourism, and affluent urban lifestyles. While 50 years of Inner Harbor gentrification have successfully positioned Baltimore for transition to the Fourth Industrial Revolution, it has also generated racial tensions that the structures and processes of conventional urban governance cannot manage. When Black neighborhoods struggling with decades of disinvestment lie adjacent to affluent white neighborhoods, race and class disparities are patently obvious. Baltimore seized upon Housing Opportunities for People Everywhere (HOPE VI), a federal program designed to foster inclusion and diversity in some of the nation’s most distressed public housing communities (U.S. Department of Housing and Urban Development 2007).

A Social Experiment in Jonestown

In 2005, those of us who bought “market rate” homes in Albemarle Square (the new name for the former Flag House Courts public housing) intentionally bought into the HUD mixed-race, mixed-income neighborhood design that positioned people of different races, incomes, and social strata next to each other on the same block. Although we live side by side, the fault lines of income, class, and race are unmistakably inscribed in differentiated architectural features. Homeowners have raised decks and private garages at the back of their townhouses; renters living in publicly subsidized housing have unadorned parking pads and concrete steps at the back of their units. Property management structures also differ accordingly. Owners pool resources to manage their properties as members of independent homeowner associations, while publicly subsidized rental units feature tenant advisory councils with little power to determine the material conditions of their neighborhood. Homeowners are a racially and ethnically diverse mix of relatively affluent couples, singles, empty nesters, and a few families whose children attend private schools. Subsidized renters are mostly young African Americanmothers, with federally funded housing choice vouchers (Section 8)Footnote 4 and children attending the local public charter school, and a sprinkling of senior citizens and people with disabilities. Except for occasional community-wide activities throughout the year, little mixing occurs among the children of homeowners and public subsidy renters. Children of homeowners participate in structured activities that their private schools and clubs sponsor. Section 8 kids may participate in school events or community center activities, but many just hang out on local streets when school is out.

When we moved to Jonestown, all the new homeowners quickly observed the lack of green spaces and play areas for kids and families. The publicly subsidized renters understood this very well, though it disturbed them less. In 2012, after years of persistent persuasion, the city demolished a crumbling building next to my house where a group of neighborhood people pooled money and volunteer labor to build a community garden. Renters and homeowners alike enthusiastically encouraged their kids to get involved in the garden. I got to know most of the people in the neighborhood and spent many hours with the kids on days when the weather was good and everyone was outdoors. We planted, watered, weeded, and harvested while chatting about everything from weather patterns and seed catalogues to school schedules, big dreams, and neighborhood gossip. I learned that by the time the neighborhood kids are teenagers, the risks of violence and trauma are baked into their moral calculus and they become remarkably resourceful in finding ways to stay safe and upbeat in a city where dangers lurk around every corner. They don’t ruminate on danger or trauma, but they are acutely aware that every venture into the street risks a potentially treacherous confrontation with gangs and the police. Yet, for 10 years, the neighborhood ambience of good will remained friendly and pleasant. Kids involved in minor disputes handled them amicably and constructively with minimal intervention. Davon and Rellvin fought over dividing up the produce of watermelons and squash they had planted, but a conversation with their mothers quickly resolved the dispute. Keisha, a neighborhood girl who hadn’t been involved in gardening, outraged the other kids when she pulled all the plants in one of the beds and threw them in the compost heap. The kids retrieved the plants from the compost and replanted them successfully, threatening to “teach Keisha a lesson.” A family-to-family conversation resolved the problem when Keisha came with her dad to apologize to the group, explaining that she felt ostracized by the “garden kids.” A group of kids (still unidentified but thought to be from another neighborhood) found their way into the toolshed one Halloween and used the stored paint to add seasonal decoration to the walls of the shed – nothing destructive or malicious, but done without permission from adults who responded by organizing more gardening activities open to any children who showed up. These small incidents demonstrated that neighborhood disputes are normal situations that adults can help resolve peacefully.

The Boys Under My Deck

Simmering below the surface, the social and economic structures of Jonestown daily life subtly but relentlessly reinforce the message that freedom, opportunity, and prosperity are readily available – but not so much for poor people of color. How is it possible, then, for young people of color to construct prosocial identities and behaviors? How is it possible for them believe in and commit to American ideals of freedom and opportunity when they cannot count on basic rights of safety and respect for their human dignity? How is it possible to believe in a remote and inaccessible government when a gang member offers money for food and shows up at a grandmother’s funeral? How is it possible to trust a trigger-happy police force eager to arrest them for hanging out in front of a corner store? How is it possible to feel safe in a city that doesn’t protect them? How is it possible to feel unsafe and devalued and also function as productive members of society?

Remarkably, despite these moral dilemmas, most of the kids in Jonestown believe in their country, their city, and in their own futures and look for ways to turn their hopes into reality. Over the years, several of the neighborhood boys – Antwon, Davon, Kevin, DaShawn, Rellvin, Travis, Dante, and their friends – started hanging out under my deck and in the garden next to my house. Through many friendly conversations, I got to know these boys – especially from the hundreds of overheard conversations they had among themselves while I was sitting on my deck alone, reading or working. I had known some of them as small boys taking care of the pumpkins and watermelons they had planted in the garden. We had ongoing conversations about what was going on in the neighborhood, how they were doing at school, what was happening with their families, girls they liked, rap songs they were creating, and whatnot. Usually they would greet me when they arrived and then go on about their business, probably forgetting that I could hear every word they are saying. The boys were (and are) well-behaved, courteous, and occasionally helpful, but sometimes there would be incidents – fights, pranks, or accidents – that prompted more pointed discussions about social rules for keeping the space safe. Charged with the responsibility for formulating and enforcing rules for good behavior, the boys would deliberate with me and among themselves about what society expects of them, what they expect of themselves, and what kind of men they were trying to be. The rules evolved to cover fighting, rowdiness, noise, tidying up, respecting property, sex (don’t ask), smoking so much weed that I could smell it in my house, and looking after the younger children and senior citizens in the neighborhood. We acknowledged milestones – going off to high school, making the football team, getting a part-time job – and dreams – graduating from high school, going to college, inventing an app, getting a good job, owning a business, or buying a house.

Like most adolescents, the boys created a space for themselves where they were free from strictures of home, school, and organized activities. Unlike more affluent adolescents, however, they had few options for free space: Lack of spending money; single mothers who (perhaps wisely) did not allow teens in their homes while they are at work or entertaining guests; recreational centers and after school programs requiring signed permission slips from parents who may be too busy, distracted, or just unavailable; gangs and police patrolling the streets for loitering kids. They spoke with clear-eyed optimism about being Black in Baltimore and I shared their confidence in their ability to navigate the treacherous moral terrain of growing up to be decent, capable young men with a bright future.

The Moral Crisis of Freddie Gray

Then, in 2015, the citywide post-Freddie Gray uptick in shootings, murders, and assaults triggered a neighborhood reaction of hypervigilance among Jonestown homeowners – white and Black – and I worried about how the boys under my deck would fare and the choices they would make in a street culture that was suddenly much more risky and threatening. Freddie Gray’s death was one of the racially violent incidents across the country that evoked “Black Lives Matter.” In Baltimore, it ultimately resulted in a federal investigation of police conduct and a court injunction against racially abusive practices by the police department. Although no evidence linked the boys in our neighborhood to criminal activity, rancorous rhetoric and suspicion peppered the homeowner email chain and website bulletin board. The boys suddenly became a threat. Regular calls to the police brought a more visible police presence. A friendly corner dry cleaning shop relocated to a different area of the city, replaced by a convenience store with barred windows and a plexiglass cage for the cash register attendant. Homeowners worried in conversations and social media about “thugs” and “juvenile delinquents”Footnote 5 hanging out in the community garden and called for stringent rules to regulate use of the garden.

At some point in late 2015 I began getting belligerent emails and text messages from homeowners about the boys under my deck. They urged me to call the police because the boys were smoking weed. They accused me of harboring criminals. They told me the space under my deck was becoming a juvenile delinquent magnet that threatened the community. They implored me to stand with the community against the threat of violence and threats from the boys under my deck. At first, I queried the veracity and motivation for the complaints: Did you actually see these kids committing illegal acts? What, specifically, were they doing? Have you seen these kids involved in illegal activities anywhere else in the neighborhood? I queried the boys: Have you been involved in anything dangerous or illegal? What about your friends? Do you know that some of the neighbors are bothered by the fact that you are hanging out under my deck? What do you think about that? What should we do about it?

These conversations were not very productive, but I did learn from the boys that doing just about anything in public “while Black” had become even more dangerous and that hanging out under my deck was a safe space. They were frustrated but unsurprised by complaints from the neighbors. They were being harassed by the police, the gangs, and even some of the more aggressively paranoid neighbors whenever they gathered in a public space. They spent several hours a day in school, at part-time jobs, hustling for jobs, or helping care for grandparents or siblings. With little money, lots of time, and no welcoming place in the neighborhood to hang out, they liked the space under my deck. I decided that, whatever my neighbors might think or do, the boys needed the space under my deck and I needed even more to share it with them since the culture had taken such a violently racist turn.

By continuing to welcome the boys and offering them a safe space under my deck, I incurred the wrath and retaliation of some homeowners – definitely a minority, but very vocal – who blocked me from neighborhood email and text chains branding me as a danger to the neighborhood. The ensuing months of almost daily encounters with the vigilante homeowners and the boys themselves were opportunities for substantive conversations about bias, race, inequality, and the rights and responsibilities of becoming adults in a complex urban society. The boys (perhaps not surprisingly) were more resilient and adaptive than some of the adults eager to criminalize adolescents they didn’t even know. A couple of the most volatile Jonestown homeowners moved away and the neighborhood has settled down, although the level of racialized street violence in the city has remained dangerously high. This has turned out to be a never-ending story that could be happening in any city neighborhood where wealth and privilege live alongside poverty and disadvantage.

Lessons Learned from the Boys Under My Deck

Five years after Freddie Gray, there are new boys under my deck and in the garden. Antwon, Davon, Kevin, DaShawn, Rellvin, Travis, Dante, and their friends are now young men who have moved on to jobs, college, girlfriends, kids, and other neighborhoods. They stop by from time to time to check in, share news, and chat. From what they tell me, despite worries about the coronavirus, they are happy and hopeful about their lives and their futures. I’m still holding my breath – their future as young Black men is risky and uncertain – but so far, they have avoided prison and death by violence or overdose.

I have learned powerful lessons about social determinants and the equitylens in building a culture of health – not only an abstraction about a world “out there” that barely touches the daily lives of professional people crafting and implementing policy, but as a practice of moral repair in rebuilding fractured relationships.Footnote 6Racialized violence is a structural problem in American society for which we all bear responsibility. An equitylens on health and wellbeing urges us to seek moral repair through deeper understanding of racialized violence and its health impact on people of color in our communities, but also on the privileged, affluent people who dominate the making of policies, norms, and practices. An equitylens enables us to seek moral repair by noticing and calling out racial violence in our everyday lives, listening to the stories of people who have been wronged, repairing the damage, and building relationships that restore justice, respect, and care. Not everyone lives in a neighborhood where the social and economic inequities of health are glaringly evident, but almost all Americans – over 80% of us – live in or near metro areas where racialized injustice threatens people’s health, denies them opportunities, and obstructs their efforts to care for themselves and their families. We all can make choices to be more neighborly, to be more proactive in creating social spaces that protect and nurture people who are vulnerable, to trust and stand with people of color, and to seek justice for people whose need for safety and wellbeing is not adequately recognized or met by the society of which we are a part.

Questions for Discussion

  1. 1.

    What ethical values does this story highlight for you and how did it affect how you think about racism and racialized violence?

  2. 2.

    What role does moral distress play in trapping boys and young men in a culture of racialized violence?

  3. 3.

    What role does privilege and authority play in racial inequity and violence in your community?

  4. 4.

    What was your emotional response to this narrative of Black boys and young men? Did it cause you to think differently about racial inequities and violence in your own personal and professional communities?

  5. 5.

    How can public health play a more active role in addressing the needs of Black and Brown young men and boys caught up in a culture of violence?

  6. 6.

    How might you use the concept of moral repair in your personal and professional life to address issues relating to racial inequity and racialized violence?

  7. 7.

    How would you use this story to begin a community conversation of moral repair and justice for boys and young men whose futures are threatened by racialized violence?